KROGER SPECIALTY PHARMACY FL 2 LLC NPI 1508146010

NPI Information

NPI: 1508146010
Provider Name: KROGER SPECIALTY PHARMACY FL 2 LLC

Doing Business As: KROGER SPECIALTY PHARMACY FL 2

Classification: Pharmacy - 3336S0011X
Entity Type: Organization

Specialization: Specialty Pharmacy

Address:
6435 HAZELTINE NATIONAL DR STE 140
ORLANDO, FL
ZIP 32822
Phone: (855) 274-1694
Get Directions

KROGER SPECIALTY PHARMACY FL 2 LLC is a specialty pharmacy pharmacy in Orlando, FL. The provider is a pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration. KROGER SPECIALTY PHARMACY FL 2 LLC NPI is 1508146010. The provider is registered as an organization entity type.
The provider Is Doing Business As Kroger Specialty Pharmacy Fl 2.

The provider's business location address is:

6435 HAZELTINE NATIONAL DR STE 140
ORLANDO, FL
ZIP 32822-156
Phone: (855) 274-1694
Fax: (855) 819-6922

The provider's authorized official is Debra J Cole .
The authorized official title is Vice President and has the following contact phone number (855) 733-3126.

The enumeration date for this NPI number is 8/29/2011 and was last updated on 9/30/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332B00000X	Durable Medical Equipment & Medical Supplies				No
2	333600000X	Pharmacy				No
3	3336C0003X	Pharmacy	Community/Retail Pharmacy			No
4	3336S0011X	Pharmacy	Specialty Pharmacy	PH25629	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	003131027B	MEDICAID	GEORGIA
2	0406827	MEDICAID	MONTANA
3	1025997	MEDICAID	VERMONT
4	1508146010	MEDICAID	UTAH
5	1508146010	MEDICAID	MISSOURI
6	200590550A	OTHER	OKLAHOMA	OKLAHOMA (P) CHILDREN WITH SPECIAL HEALTHCARE NEEDS PROGRAM VENDOR
7	201116160A	OTHER	KANSAS	KANSAS (QMB)
8	201116160B	OTHER	KANSAS	KANSAS (P) (CHILDREN WITH SPECIAL HEALTHCARE NEEDS)
9	3102337	MEDICAID	NEW HAMPSHIRE
10	3106044	MEDICAID	NEW HAMPSHIRE
11	7F5629	MEDICAID	SOUTH CAROLINA
12	0518565	MEDICAID	NEW JERSEY
13	18-20-CC-9559	OTHER	KENTUCKY	KENTUCKY (CHILDREN WITH SPECIAL HEALTH CARE NEEDS)
14	27828701	MEDICAID	NEW MEXICO
15	Q036221	MEDICAID	TENNESSEE
16	097296	MEDICAID	ARIZONA
17	1508146010	MEDICAID	VIRGINIA
18	1508146010	MEDICAID	MICHIGAN
19	201121900A	MEDICAID	INDIANA
20	216017	MEDICAID	ALABAMA
21	Q036221	OTHER	IDAHO	IDAHO (P) (CHILDREN WITH SPECIAL HEALTHCARE NEEDS)
22	004264400	MEDICAID	FLORIDA
23	004264401	MEDICAID	FLORIDA
24	0506711	MEDICAID	NEW JERSEY
25	1508146010	MEDICAID	NEVADA
26	1508146010	MEDICAID	IDAHO
27	163522375	MEDICAID	FLORIDA
28	2049652	MEDICAID	VIRGINIA
29	500686927	MEDICAID	OREGON
30	003131027A	MEDICAID	GEORGIA
31	0406939	MEDICAID	MONTANA
32	103011190-0001	MEDICAID	PENNSYLVANIA
33	1508146010	MEDICAID	NORTH CAROLINA
34	DM1542	MEDICAID	SOUTH CAROLINA
35	0212596	MEDICAID	IOWA
36	1508146010	MEDICAID	WISCONSIN
37	64770109	MEDICAID	COLORADO
38	15-17-CC-9559	OTHER	KENTUCKY	KENTUCKY (CHILDREN WITH SPECIAL HEALTH CARE NEEDS)
39	150015500	MEDICAID	MARYLAND
40	1508146010	OTHER	FLORIDA	FLORIDA CHILDREN'S MEDICAL SERVICES
41	16221397	MEDICAID	NEW MEXICO
42	500687694	MEDICAID	OREGON
43	7100257570	OTHER	KENTUCKY	KENTUCKY (P), PASSPORT HEALTH PLAN, WELLCARE OF KENTUCKY
44	100264920-00	MEDICAID	NEBRASKA
45	1508146010	OTHER	INDIANA	INDIANA CHILDREN'S SPECIAL HEALTH CARE SERVICES PROGRAM
46	1508146010	MEDICAID	MINNESOTA
47	2131644	OTHER		PK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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